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Undergraduate Exhibition Performance Entry Form

Directions: Please complete and submit the following form. Print out a copy of the completed form and obtain the required teacher/coach's signature. Turn this in to 417 Old Main by 5:00 PM on March 7, 2008. THE DEADLINE FOR ENTRIES HAS BEEN EXTENDED TO FRIDAY, MARCH 21.

Personal Information Penn State Student ID:
(example 999999999)

First Name:
Middle Name:
Last Name:
Semester Standing:
Major:
College/Campus:
Local Address:
Local Phone:
Email:
Department/Division:

Additional Performer Information Name:
Email:
Major:

Name:
Email:
Major:

Name:
Email:
Major:

Accompanist Information(if applicable) Name:
Email:
Major:

Applied Instructor/Coach Information

Please give the following information about your applied instructor/coach:

First Name:
Last Name:
Department:
Campus Address:
Campus Phone:
Email:

Second Applied Instructor/Coach Information

If you had a second applied instructor/coach, please fill in the information below:

First Name:
Last Name:
Department:
Campus Address:
Campus Phone:
Email:

Academic Adviser Information

Please fill in the following information about your academic adviser:

First Name:
Last Name:
Department:
Campus Address:
Campus Phone:
Email:

Performance Information

Please choose the appropriate type for your entry:

Solo Entry
Ensemble Entry

Please choose the appropriate formatting options:

I require music stands for my performance.
Number of stands needed:

I require chairs for my performance.
Number of chairs needed:

I require a piano for my performance.

Title of Piece to be Performed:

Composer/Author:

Abstract: Note: This abstract will be published in the official Undergraduate Exhibition program.

The Office of Undergraduate Education should be notified at least two weeks in advance of any cancellations.

A signature form will appear after pressing the "Submit Form" button. Please print this and have it signed by the appropriate advisers, then submit the signed form to 417 Old Main.

NOTE: YOU WILL NEED TO TURN IN THE SIGNED FORM. YOUR APPLICATION IS NOT CONSIDERED COMPLETE UNTIL THIS FORM IS SUBMITTED BOTH ELECTRONICALLY AND IN HARD-COPY FORMAT WITH APPROPRIATE SIGNATURES. A SIGNATURE FORM WILL APPEAR FOR YOU TO PRINT AFTER YOU CLICK "SUBMIT." BE SURE TO PRINT A COPY BEFORE CLOSING THE WINDOW; THE FORM CANNOT BE ACCESSED AGAIN ONCE THE WINDOW IS CLOSED. THIS SIGNATURE FORM MUST BE RETURNED TO 417 OLD MAIN BY March 7, 2008.

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Undergraduate Exhibition Performance Entry Form

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